Diferentes modelos para avaliar a relação custo-efetividade de inibidores de tirosina quinase do EGFR no tratamento do câncer de pulmão não pequenas células metastático no contexto do Sistema Único de Saúde

Translated title of the contribution: Distinct models to assess the cost-effectiveness of egfr-tyrosine kinase inhibitors for the treatment of metastatic non-small cell lung cancer in the context of the Brazilian unified health care system

Pedro Aguiar, Felipe Roitberg, Gilberto Lopes, Auro del Giglio

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: Lung cancer is an important health problem due to its high incidence and mortality. The treatment of metastatic disease improved after the molecular pathways of cancer came to be known. However, targeted therapy is unavailable to many patients treated within the Brazilian Sistema Único de Saúde (SUS, Unified Health Care System). Our objective was to assess the cost-effectiveness of erlotinib, gefitinib, and afatinib versus that of chemotherapy for the treatment of non-small cell lung cancer in the context of the SUS. Methods: Different analytical models were developed based on data in the literature. The outcomes were presented in quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) per QALY gained. All costs related to treatment and supportive therapies were included in the models. Results: In one model, data from retrospective studies showed 2.01 life-years saved and a mean QALY gain of 1.169. The ICER per QALY gained ranged from R$48,451.29 (for gefitinib) to R$85,559.22 (for erlotinib). In another model, data from a meta-analysis showed −0.01 life-years saved and a mean QALY gain of 0.178. The ICER per QALY gained ranged from R$27,028.30 (for gefitinib) to R$75,203.26 (for erlotinib). Conclusions: There is no ideal analytical model for the SUS. However, targeted therapy with EGFR-tyrosine kinase inhibitors has been shown to be cost-effective in various scenarios. The adoption of drug price discounts will improve the cost-effectiveness of treatment.

Translated title of the contributionDistinct models to assess the cost-effectiveness of egfr-tyrosine kinase inhibitors for the treatment of metastatic non-small cell lung cancer in the context of the Brazilian unified health care system
Original languagePortuguese
Article numbere20180255
Pages (from-to)1-7
Number of pages7
JournalJornal Brasileiro de Pneumologia
Volume46
Issue number4
DOIs
StatePublished - 2020

Keywords

  • Brazil
  • Economics, pharmaceutical
  • Health policy
  • Molecular targeted therapy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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